title: Endocarditis due to Aspergillus flavus.
abstract: Fungal endocarditis has emerged as an important complication of patients undergoing cardiovascular surgery. Our patient had no past history of cardiac surgery, intravenous drug abuse or immunosuppressive therapy. He had received broad-spectrum antibiotics for varying periods, which might have predisposed him to this infection. The diagnosis was based on the demonstration of hyaline, septate branched fungal elements in the infected valvular tissue and isolation of Aspergillus flavus in culture. The delay in establishing the ante-mortem diagnosis because of repeatedly negative blood cultures, presence of disseminated intravascular coagulopathy and rapidly deteriorating kidney function were the major factors contributing to his poor prognosis and death, despite surgical removal of infected valves and antifungal therapy. This is the first report of endocarditis due to A. flavus from the Middle East.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
authors.forename: Z U
authors.initials: ZU
authors.lastname: Khan
authors.forename: S C
authors.initials: SC
authors.lastname: Sanyal
authors.forename: E
authors.initials: E
authors.lastname: Mokaddas
authors.forename: I
authors.initials: I
authors.lastname: Vislocky
authors.forename: J T
authors.initials: JT
authors.lastname: Anim
authors.forename: A L
authors.initials: AL
authors.lastname: Salama
authors.forename: H
authors.initials: H
authors.lastname: Shuhaiber
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D001231:Aspergillus flavus; D004696:Endocarditis / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B